Report weighs viability of county nursing homes in NY state

Cost-benefit analysis finds mixed results

A new report on county-owned nursing homes in New York offers a wealth of information and plenty of debate fodder for counties such as Orange that have wrestled with the question of whether to keep or privatize their homes.

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By Chris McKenna

recordonline.com

By Chris McKenna

Posted Sep. 3, 2013 at 2:00 AM

By Chris McKenna

Posted Sep. 3, 2013 at 2:00 AM

» Social News

A new report on county-owned nursing homes in New York offers a wealth of information and plenty of debate fodder for counties such as Orange that have wrestled with the question of whether to keep or privatize their homes.

The 162-page analysis by the Center for Governmental Research, a Rochester-based think tank, looks at the rising costs that have pushed some counties toward privatization, the complex range of considerations they face, and the mixed results observed in four counties that have sold their nursing homes since 2005.

Thirty-three counties outside of New York City — including Orange, Ulster and Sullivan — owned and ran nursing homes as of January, although the total has since dipped to 31 with the sale of Ulster's Golden Hill Health Care Center in late June and the closure of Suffolk County's home days later. Seven other counties are in the process of selling their homes, according to the report.

Perhaps the biggest expense challenge the report identified was the cost of employee pensions and health insurance, which climbed 181 percent over a decade. That far outpaced the price increase at privately owned nursing homes, which offer less generous benefits.

On the revenue side, counties must contend with low Medicaid payments and their tendency to serve the neediest. About 25 percent of residents admitted to county nursing homes are on Medicaid, compared to 10 percent at private facilities, according to the report.

During their year-long study, funded by the New York State Health Foundation, researchers examined how the sales of nursing homes in Delaware, Fulton, Montgomery and Oswego counties has affected care for their mostly elderly residents and other factors.

The most alarming outcome occurred in Delaware. After three investors bought that home in 2006, staffing levels dropped and care deficiencies rose, prompting the state to monitor and then close the home last October. Some 120 residents were forced to move to homes as far away as Albany.

Researchers found more positive results in Montgomery and Oswego counties. "In Montgomery," they wrote, "resident care and the finances of the home have clearly improved, though there are some concerns that hard-to-place residents have less access to the home now than they did when it was county-owned."

In Orange County, County Executive Ed Diana has been pressing lawmakers to sell the Valley View Center for Nursing Care and Rehabilitation since 2011, arguing that its costs are unsustainable. The home remains in county hands after two budget battles and a lawsuit by the Legislature, although another budget showdown is likely to come soon.

For lawmakers weighing both sides in the debate, the new report (available online at www.cgr.org) offers criteria for evaluating Valley View's role in long-term care. It also offers recommendations for lowering costs and protecting or enhancing revenue if the facility remains in county hands.